Con: Should Varicocele Be Repaired in Azoospermic Infertile Men?

Abstract

In this debate, we will present the view why repair of clinical varicoceles should not be rou- tinely performed for all men with non-obstructive azoospermia (NOA). We will focus this discus- sion in the context of infertility and exclude the other indications of varicoceles repair including pain/discomfort, aesthetic improvement, and cor- rection/reduction of low testosterone risk. As eloquently presented by Sandro C. Esteves in Chap. 44, there are several reasons why many reproductive urologists come to the conclusion that when counselling non-obstructive azoosper- mic men, correction of clinical varicoceles first to optimize testicular function should be recom- mended. This approach unfortunately is not sup- ported by evidence available in the current literature. This incorrect view was a result of a combination of faulty assumptions and inappro- priate extrapolations and generalization of the out- comes of varicocele repair to all men with NOA